Desipramine Hydrochloride and Filgrastim For Stem Cell Mobilization in Patients With Multiple Myeloma Undergoing Stem Cell Transplant

Inclusion Criteria:

Patients eligible for autologous stem cell transplant for multiple myeloma; planned use of filgrastim (GCSF) for stem cell mobilization
Ability to give informed consent
Glomerular filtration rate (GFR) > 30 ml/minute
Liver function tests < 2.5 x upper limit of normal (ULN)
Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2 or less

Based on prior therapy patients will be classified into two categories:

Initial mobilizers with no exposure to alkylators
Remobilizers or with prior exposure to alkylators or with greater than 5 cycles of lenalidomide therapy prior to mobilization

Exclusion Criteria:

Use of a monoamine oxidase inhibitor (MAO-I) during or within 2 weeks of desipramine therapy
Concomitant therapy with any drugs shown to have major interactions with desipramine
Concurrent use of drugs that are contraindicated with desipramine
Myocardial infarction in preceding 4 weeks; history of uncontrolled cardiac arrhythmias or family history of sudden cardiac death; baseline corrected QT (QTc) > 460 msec
Active alcohol abuse
Bipolar disorder
Untreated active major depression
History of seizures in the past 3 years
Pregnancy and lactation; refusal to use adequate contraception
Uncontrolled thyroid disease
GCSF or pegfilgrastim use within 14 days prior to enrollment
Bortezomib, Revlimid or thalidomide use within 7 days of enrollment
Patients with sickle cell disease